mr. chairman , i do rise in strong opposition to this amendment . 
i certainly support denying impotence drugs to sex offenders , but to arbitrarily eliminate any class of drugs from a formulary , first of all , sets a terrible precedent and has the same potential for mischief as state mandates on health plans have demonstrated is possible . 
so the precedent being set here is one i object to . 
but much more important , these drugs are often medically necessary . 
ed drugs help men who have lost sexual function caused by prostate cancer , diabetes , multiple sclerosis , nerve damage , or cardiac conditions . 
it is important that these drugs are available when they are medically appropriate and there is no evidence of abuse for medically appropriate situations . 
they are not sold over the counter , they are prescription , must be prescribed by a physician , and they are so important in the cases where they are medically needed , that it would be , in my mind , a gross disservice to our seniors to automatically deny them access under our prescription drug program to these drugs . 
first of all , where does this approval end ? 
we do not say to seniors , we will not prescribe cholesterol medications for you or drugs for high blood pressure until you have changed your diet and exercised . 
yet diet and exercise could eliminate the need for taxpayer-funded drugs in many categories , but we do not require that . 
secondly , we are very interested in , and increasingly interested in , early identification and prevention of serious illness , and sexual dysfunction is often an early sign of other very serious conditions . 
those diseases may go untreated and undetected if there is no need to go to the doctor to talk about impotence , to evaluate the causes of impotence and , therefore , be entitled to the prescription . 
so it interferes with early diagnosis and prevention in certain diseases . 
it is also extremely important to consider this issue in the context of mental health and the costs of mental health in our elderly population . 
certainly , in a long-term marriage , a healthy sexual relationship is important to the strength of that relationship and important to the mental health of the people involved . 
would we rather pay for depression treatment , or would we rather have that couple eligible for the kind of medications that the gentleman wishes to ban from the medicare program ? 
so if we take a holistic approach to health and remember that mental health is important to reducing the cost of physical disease and that early identification and prevention of serious health problems is extremely important to lowering the long-term costs of medicare and giving the program sustainability that is crucial to the well-being of our seniors , then my colleagues will vote against this amendment , even though i appreciate that , superficially and politically , voting for it would be a desirable vote . 
i would urge my colleagues to oppose the availability of these drugs for sex offenders . 
i would urge my colleagues to oppose eliminating them from the medicare formulas , because they are often medically appropriate and they are important to the long-term health and well-being and early identification of disease in our seniors . 
